Customer Onboarding / RPM Equipment

Customer Onboarding

Please Fill Out Form Below
RPM Equipment Sales Rep Name*
Date*

MonthDayYear
Date
Contact Name*
Email Address*
Phone Number*
Business Name*
DBA if Applicable*
Federal Tax ID*
Address*

Physical Address

Street Address Line 2

CityState

Zip
*Billing Address (If Different Than Above)*
Address

If different than above

Street Address Line 2

CityState

Zip
Tax Exempt (If Yes, Please Include Exemption Certificate)

YesNo
Length Of Time In Business
*Credit Application*

(If you do not wish to apply for credit, do not fill out the next section, and scroll to bottom to submit the above information)
I. BUSINESS INFORMATION
Type Of Business

CorporationPartnershipGovernmentSole ProprieterLLCOther
II. BILLING INFORMATION
Job Name Or Number
Purchase Order
Accounts Payable Email
example@example.com
Monthly Statements

YesNo
III. APPLICANT INFORMATION
Name
Title
SSN
Address

Physical Address

Street Address Line 2

CityState

Zip
Email Address
example@example.com
Phone Number
Insurance Company
Name & Address
Phone Number
Fax
Note: If you plan to utilize our rental services and do not wish to pay a physical damage waiver charge, please have your insurance company forward a Certificate of Insurance covering rented or leased equipment with our company as "Certificate Holder" and named as loss payee or additional insured.
IV. BANKING INFORMATION
Bank Name
Contact Name
Phone Number
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
State
Zip Code
Bank Account
Routing
V. TRADE REFERENCES
Business Name
Contact Name
Email Address
example@example.com
Business Name
Contact Name
Email Address
example@example.com
Business Name
Contact Name
Email Address
example@example.com
VI. CONTRACT TERMS & CONDITIONS
Applicant hereby applies to RPM Crushers & Screens, LLC for credit and specifically consents to investigating Applicant's credit history and authorizes the release of its bank account information. If credit is extended, Applicant acknowledges that RPM Crushers & Screens, LLC requires payment upon receipt of invoice. Invoices are considered past due at 31 days. In the event of failure to timely pay any invoice, Applicant agrees to pay a service charge to RPM Crushers & Screens, LLC on such delinquent invoice(s) until fully paid, at the maximum rate allowed by the laws and jurisdiction of the originating location stated on the invoice, and collection costs and/or attorney's fees in an amount that is not less than 25% of the outstanding balance owed. At the discretion of RPM Crushers & Screens, LLC, any account with a delinquent balance may be placed on a cash basis at any time, and the equipment picked up without notice.

Additionally, RPM Crushers & Screens, LLC reserves the right to pursue remedies available to it under the party's contracts at law or in equity. Applicant agrees to be bound by the terms and conditions as set forth in RPM Crushers & Screens, LLC Agreement, or similar document, in use at the time of each rental or sales transaction in the jurisdiction where the purchase or rental occurs, which terms and conditions are incorporated herein by reference and which constitute a part of the credit agreement, regardless of whether or not the agreement is executed by an authorized representative of Applicant. RPM Crushers & Screens, LLC reserves the right to file preliminary notices for work done in states where these notices are required by state law in order to protect our lien rights.
Signature

Clear
Date

MonthDayYear
Date
Title
Print Name of Applicant
VII. PERSONAL GUARANTY
The undersigned guarantor(s), for and in consideration of RPM Crushers & Screens, LLC extending credit at my/our request to the Applicant named above, in which I/we have a financial interest, jointly, severally and unconditionally personally guarantee prompt payment and performance of any obligations of Applicant to RPM Crushers & Screens, LLC whether now existing or hereinafter made, and further agree to bind myself/ourselves to pay on demand any sum which is due by Applicant to RPM Crushers & Screens, LLC whenever Applicant fails to pay the same. It is understood that this guaranty shall be absolute, continuing and irrevocable for such indebtedness of Applicant. I/We expressly waive presentment, demand, protest, my/our homestead exemption as to this debt, notice of protest, dishonor, diligence, maturity, default or nonpayment, acceptance of this guaranty, extending of any guaranteed indebtedness already or hereafter contracted for by Applicant, any modifications or renewals of any credit agreement evidencing the indebtedness hereby guaranteed and all setoffs and counterclaims. If collection of amounts due requires the assistance of a collection agency or attorneys, suit is brought heron, or it is enforced through any judicial proceeding whatsoever, I/We agree (a) that RPM Crushers & Screens, LLC reserves the right to bring legal action in whatever jurisdiction RPM Crushers & Screens, LLC deems necessary, whose laws, at the option of RPM Crushers & Screens, LLC, shall govern this Agreement, and (b) to pay all costs and expenses of collection, including reasonable attorney's fees not exceeding a sum equal to twenty five (25%) of the outstanding balance owing, plus all other reasonable expenses incurred by RPM Crushers & Screens, LLC in exercising any of RPM Crushers & Screens, LLC rights and remedies. The Undersigned recognizes the obligation of the Applicant and the undersigned agrees to hold the portion of all payments received by Applicant which include payment to Applicant for the rent and/or purchase of equipment and supplies furnished by RPM Crushers & Screens, LLC pursuant to this agreement to be held in a separate trust account for payment to RPM Crushers & Screens, LLC. The undersigned agrees to act as fiduciary for payment to RPM Crushers & Screens, LLC and agrees that Applicant shall not use said payments for any other purpose, in exchange for the Applicant's ability to rent and/or purchase equipment and supplies on a credit account. The undersigned agrees that any failure to hold payments in trust for RPM Crushers & Screens, LLC shall create a debt which is not dischargeable in bankruptcy and which shall be an exception to discharge pursuant to the terms of 11 USC 523(a4) and (6 The undersigned represent that (i) the information contained in the Agreement is a true and correct statement of the financial condition of the Applicant; and (ii) a photo copy or facsimile copy of this Agreement shall be valid as the original. If any part of this Agreement is held unenforceable, the remainder of this Agreement shall not be affected thereby. The undersigned herby waives the right to a jury trial of any or all claims or disputes which may arise from this Agreement. RPM Crushers & Screens, LLC shall not be required to exhaust all remedies against Applicant prior to exercising its rights against Guarantor(s I/We authorize RPM Crushers & Screens, LLC to make whatever credit inquiries it deems necessary in connection with this Agreement. Bank and trade reference(s) can accept this authorization to disclose to RPM Crushers & Screens, LLC and/or their respective designees (and any assignee or potential assignee thereof), Guarantor(s) information normally released to a prospective creditor including: length of time account has been active, average monthly balances, how the account has been handled, and details of any lending relationship.
Guarantor's Signature

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Please Print Name
Date

MonthDayYear
Date
Address

Address

Street Address Line 2

CityState

Zip
Signature

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Please Print Name
Date

MonthDayYear
Date
Address

Address

Street Address Line 2

CityState

Zip
Should be Empty:

Customer Onboarding

I. BUSINESS INFORMATION

II. BILLING INFORMATION

III. APPLICANT INFORMATION

IV. BANKING INFORMATION

V. TRADE REFERENCES

VI. CONTRACT TERMS & CONDITIONS

VII. PERSONAL GUARANTY